| NPI | 1164081121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TN 8677) |
| Additional Taxonomies | 104100000X Social Worker |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2023-12-08 |